Tuesday, March 17, 2015

St. Paddy's Day Obamacare Update

The Kansas-based National Rural Health Association, which represents about 2,000 small hospitals across the country and other rural care providers, says that 48 rural hospitals have closed since 2010, the majority in Southern states, and 283 others are in trouble. In Texas alone, 10 have closed.
. . .
Experts and practitioners cite declining federal reimbursements for hospitals under the Affordable Care Act as the principal reasons for the recent closures. Besides cutting back on Medicare, the law reduced payments to hospitals for the uninsured, a decision based on the assumption that states would expand their Medicaid programs. However, almost two dozen states have refused to do so. In addition, additional Medicare cuts caused by a budget disagreement in Congress have hurt hospitals’ bottom lines.

Nearly 200,000 insured Coloradans will lose their health-care plans next year under the state’s embattled Obamacare exchange, Connect for Health Colorado.

State insurance commissioner Marguerite Salazar touched off an outcry Friday by confirming to news outlets that health-care policies covering 190,000 people will be dropped in 2016 because they fail to comply with the Affordable Care Act.

Colorado Senate Majority Leader Bill Cadman called the action “a huge blow to another 190,000 Coloradans who will be forced out of their existing healthcare plans.”

A year ago, President Obama extended the deadline on policies that failed to meet Obamacare’s heightened coverage requirements, allowing policyholders to renew their old coverage through 2016, but Ms. Salazar decided that a one-year extension was enough, said her spokesman, Vincent Plymell.

But most of them will get subsidized Obamacare policies that cover more than the customer wants to pay, courtesy of the tax payers.

“Patients with symptoms of coronary artery disease (CAD) who underwent coronary computed tomographic angiography (CTA) did not have better clinical outcomes than those who had functional testing. . . . Using CTA did not reduce the composite incidence of death, myocardial infarction, hospitalization for unstable angina, and procedural complications at 12 months. Event rates were low in both groups: 164 patients (3.3%) in the CTA group and 151 patients (3.0%) in the functional testing group. Overall radiation exposure was higher in the CTA group compared to the functional testing group, which included nuclear stress testing, stress echocardiography, and exercise electrocardiogram. One third of patients in the functional-testing group had no radiation exposure at all.”

I’m not saying this is wrong, I’m just noticing.

Medicine, like all other sciences, is wrong all the time, but hopefully it's self-correcting. When the government becomes involved in paying for and deciding which treatments work best, the incentives become skewed towards lowest cost, and not the best combination of effect and economy.